Perspective theheart.org on Medscape Trials and Fibrillations with Dr John Mandrola. COMMENTARY. Statins in Primary Prevention: Welcome to the Gray Zone. John Mandrola. Disclosures. February. It remains unclear whether primary prevention strategies for CVD are effective in high grade inflammatory conditions such as RA and there are no previous, CVD outcome statin trials in patients with RA. TRACE RA was designed to assess whether atorvastatin 40mg daily is superior to placebo for the primary prevention of CVD events in patients with RA. ♦ ASCOT-LLA supports the use of atorvastatin 10mg daily for primary prevention of CHD & stroke in hypertensive male patients (especially 60years of age) with multiple risk factors for CHD and total cholesterol levels ≤6.5 mmol/L. Atorvastatin, sold under the trade name Lipitor among others, is a statin medication used to prevent cardiovascular disease in those at high risk and treat abnormal lipid levels. For the prevention of cardiovascular disease, statins are a first-line treatment. It is taken by mouth. These end points may have diluted the atorvastatin effect, which is evident in the clinical end points of fatal and nonfatal myocardial infarction and the 28% reduction in CHD death and nonfatal myocardial infarction in the secondary prevention cohort, within the range of that for other secondary prevention trials (13–55%) (10–13). Thus the coronary benefit in primary prevention trials appears to be limited to men, RR 0.74 [0.68-0.81], ARR 2.0%, NNT 50 for 3 to 5 years. References Shepherd J, Blauw GJ, Murphy MB, et al. PROSPER study group. The aim of this updated systematic review is to assess the effects, both in terms of benefits and harms of statins, for the primary prevention of CVD. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE until 2011. Abstract. Atorvastatin has been extensively studied in the primary and secondary prevention of cardiovascular events, and may have some clinical advantages over various other statins in these respects. Rosuvastatin in primary prevention. Clinical studies have demonstrated the benefits of statins in primary prevention. This is believed principally to be secondary to reduction in LDL-C, high sensitivity C-reactive protein (hsCRP) and elevation of HDL-C though other effects are recognised. Moved Permanently. The document has moved here.